Caregiving (in the Twenty-First Century)

As a society and as individuals, family and friends are the fundamental framework for growth, support, and care. These support systems have incredible influence, both positive and potentially negative. Family caregivers, family by birth or family by choice, impact one’s health, social and economic well-being, and overall life experience. These effects are magnified at the extremes of the lifespan when needs often compound. For older adults, caregivers often play an integral role in the well-being and independence of their individual care recipients. In the United States there is greater need for caregivers to coordinate complex care and to access and utilize societal support systems, at times from a distance. Person-centered care involves understanding the values and wishes of the care-recipient and is central to effective caregiving and quality of life (and death) for older adults. This chapter describes the demographics and changing epidemiology of caregiving, tasks carried out by caregivers, and the impact of caregiving on health outcomes of both older adults and the caregivers themselves. It will touch upon interdisciplinary management of patients with caregiving needs, education and support of caregivers, and the importance of incorporating caregiving into advance care planning discussions. We conclude by highlighting gaps in knowledge and the need to focus research on models of care that aim to improve outcomes for older adults and their caregivers.